What is Freiberg’s Disease?

• This is a condition that is characterized by cartilage degeneration of the lesser metatarsal heads. This often leads to infarction and fracture of the metatarsal heads.
• Most commonly affected population are adolescent females, and the most common affected metatarsals are the 2^nd and 3^rd, rarely happening with the 4^th and 5^th.
• The etiology is mostly unknown, but can often be attributed to abnormal biomechanics, genetic predisposition, and vascular compromise.
• Risk factors include those with long 2^nd metatarsals
• Diagnosis is made clinically from pain to the forefoot with associated swelling and stiffness to the joint. This is usually worse with weightbearing and exercise. Range of motion to the joint can be stiff and painful. Radiographically one can see subchondral sclerosis, flatting of the metatarsal head, and joint destruction.

How is Freiberg’s Disease Treated?

• Nonoperative management starts with immobilization to calm the inflammation down with activity modification and often a boot or cast. Anti-inflammatories can play a large role in symptom management as well as oral or injectable steroids. Controlling biomechanics with custom inserts is crucial to help prevent the progression of the disease.
• There are several surgical options for this disease if conservative management fails that should be discussed with a foot and ankle surgeon.

If you struggle with toe joint pain or have been previously diagnoses with Freiberg’s, come see a Foot and Ankle Specialist such as Dr. Garrett Nelson to make sure you are on the road to recovery with proper diagnosis and treatment.